UTILIZATION OF PRESCRIPTION MEDICATIONS AND MEDICATIONS LABELLED FOR SUICIDE RISK AMONG VETERANS WITH POST-TRAUMATIC STRESS DISORDER, BIPOLAR AFFECTIVE DISORDER, MAJOR AFFECTIVE DISORDER AND/OR SCHIZOPHRENIA IN A PRAGMATIC RANDOMIZED TRIAL

Author(s)

Lavigne JE1, Brown T2, Gutierrez P3
1Wegmans School of Pharmacy St John Fisher College, Rochester, NY, USA, 2US Department of Veterans Health Affairs, Canandaigua, NY, USA, 3US Dept of Veterans Health Affairs, Denver, CO, USA

OBJECTIVES: To describe the prescription drug utilization of 243 Veterans with post-traumatic stress disorder, schizophrenia, bipolar disorder or major affective disorder who both enrolled and completed at least 2 assessments for a pragmatic randomized trial of blister packaging versus dispensing as usual of all prescribed medications in Denver, Colorado between 2012 and 2014. The intervention was designed to improve adherence and reduce suicide risk. METHODS:   Trial records were linked to VHA Corporate Data Warehouse (CDW) prescription fill records for the study period by unique patient ID. This study was reviewed and approved by the VISNs 2 and 19 Human Subjects Review Boards and the Department of Defense Human Research Protections Office. RESULTS:   CONCLUSIONS: This pragmatic randomized trial was designed to improve medication adherence among Veterans who may be at elevated risk of suicide or overdose due to schizophrenia or bipolar disorder, for example. Both are associated with increased risk of suicide. The most prevalenet prescription medications in this pragmatic trial were antidepressants and anticonvulsants, all of which are labelled for risk of suicidal ideation and behavior. Further examination of combination prescribing refinement of warning labels for suicide risk may support future adherence and prevention efforts. LIMITATIONS: Prescription fills outside of VA were not observed.

Conference/Value in Health Info

2017-05, ISPOR 2017, Boston, MA, USA

Value in Health, Vol. 20, No. 5 (May 2017)

Code

PHP57

Topic

Health Service Delivery & Process of Care

Topic Subcategory

Prescribing Behavior, Treatment Patterns and Guidelines

Disease

Mental Health, Multiple Diseases

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